Provider Demographics
NPI:1679520258
Name:MIDWEST DIVISION - LRHC LLC
Entity type:Organization
Organization Name:MIDWEST DIVISION - LRHC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-259-6893
Mailing Address - Street 1:1500 STATE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1107
Mailing Address - Country:US
Mailing Address - Phone:660-259-2203
Mailing Address - Fax:660-259-6819
Practice Address - Street 1:1500 STATE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1107
Practice Address - Country:US
Practice Address - Phone:660-259-2203
Practice Address - Fax:660-259-6819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO010568509Medicaid
KS90036022OtherBLUE CROSS
515720OtherFIRST GUARD
757000OtherFAMILY HEALTH PARTNERS
8316OtherHEALTHCARE USA
MO010568509Medicaid